TITLE:
Epidemiologic Aspects of Atrial Fibrillation in a Tertiary Hospital in a Sub-Saharan Africa Setting
AUTHORS:
Félicité Kamdem, Ba Hamadou, Marius Kamdem, Christ Nadège Nganou, Anastase Dzudie, Yves Monkam, Samuel Kingue
KEYWORDS:
Epidemiology, Atrial Fibrillation, Cameroon, Sub-Saharan Africa
JOURNAL NAME:
Open Access Library Journal,
Vol.4 No.2,
February
22,
2017
ABSTRACT: Background:
Atrial fibrillation (AF) is the most frequent sustained
arrhythmia. The prevalence is increasing with that of other cardiovascular risk
factors in our low-income setting. It is potentially serious due to the
associated complications. Few data exist on the epidemiology of AF in
Sub-Saharan Africa (SSA). Methodology: We carried out a cross-sectional study
between 2005 and 2009 in the Cardiology Unit of the Douala General Hospital.
Patients were adults ≥ 18 years of both sex, who had an ECG diagnosis of Atrial
Fibrillation and a comprehensive investigation of the cause of AF. Results: A
total of 2581 patients were seen in this unit, of whom 182 (7.1%, [95%: 6.1-8.1]) had AF. Their mean age was 59.2 ± 15.4 years,
and there were 100 (58.2%, [95% CI: 51-65.6], p = 0.002) females. Hypertension was the most frequent risk factor
(77.3%, [95% CI: 70.3-82.8]), and 163 (95.3%, [95% CI: 90.7-97.8]) of the
patients were symptomatic. Hypertensive heart disease (45.6%, [95% CI: 38.3-53.1]), idiopathic dilated cardiomyopathy (19.3%, [95% CI: 14.1-25.9]), and
valvular heart disease (16.4%, [95% CI: 11.6-22.6]) were the main etiologic
factors of AF. The most frequent complications were heart failure seen in 77
(45%, [37.8-52.5]) and ischemic stroke in 27 (15.5%, [95% CI: 11.1 - 22]) of
patients. Digoxine was prescribed in 121 (70.8%, [95% CI: 63.6-77.1]) patients
to control heart rate, while amiodarone was prescribed in 67 (29.2%, [95% CI:
32.2-46.7]) patients to revert to sinus rhythm. No electrical cardioversion
was carried out. Aspirine was prescribed in 119 (69.6%, [95% CI: 62.3-76])
patients, and anti-vitamin K in 53 (30.4%, [95% CI: 24.5-38.3]) patients. Conclusion:
Atrial fibrillation was seen in seven percent of patients in the Cardiology Unit of this low-income setting.
Patients were relatively young compared with high income settings. Hypertension, idiopathic
dilated cardiomyopathy, and valvular heart disease were the main causes. Rate
control was the main treatment strategy. Oral anti-coagulants were less
frequently used.